Many surgical suturing instruments have been developed to assist surgeons in threading suture through tissue. A typical suturing instrument currently used for suturing during endoscopic surgery includes at one end movable jaws for grasping and releasing a needle, and at the opposite end a scissor-like control handle, which is used to open and close the jaws and to move the needle. The surgeon grasps the needle by closing the jaws around it, and then inserts the needle into and through the tissue and opens the jaws to release the needle. Next, the surgeon uses the same instrument or similar tool to grasp the needle and pull it through the tissue. The movements are repeated, as necessary, to complete the suturing procedure.
During suturing, the surgeon has to release and re-grasp the needle a number of times. Each time the surgeon re-grasps the needle, the needle must be positioned and oriented correctly within the jaws, so that it is readily inserted into and through the tissue to make another stitch. Accordingly, the surgeon must first determine the position and orientation of the needle in the jaws. This operation is difficult, particularly in endoscopic procedures, because the view of the needle and of the instrument is via a two-dimensional image transmitted by a camera to the surgeon. Next, the surgeon must adjust the needle within the jaws, as necessary, which is also difficult because the jaws only open and close. Further, the surgeon must ensure that the needle is not dropped, since the needle may be difficult to locate in the transmitted image. Once a dropped needle is located, picking it up is difficult, particularly with the suturing instrument. Often, a special instrument and another hand to manipulate the instrument are required.
Accordingly, it would be desirable to provide a suturing instrument that can be accurately positioned and oriented relative to the tissue to be sutured, and that can be further manipulated in an efficient, consistent and precise manner even in very tight surroundings such as arthroscopic or laproscopic surgery. A suturing instrument which eliminates the need for mechanical jaws, and which is easy to employ in minimally invasive procedures or other procedures in which the direction of the access to the tissue to be sutured is limited, is also desirable.